| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2023 |
Targeted case management; per month |
7,818 |
7,714 |
$4.20M |
| T1016 |
Case management, each 15 minutes |
32,111 |
8,738 |
$1.55M |
| T2003 |
Non-emergency transportation; encounter/trip |
10,319 |
1,000 |
$168K |
| S0215 |
Non-emergency transportation; mileage, per mile |
9,961 |
1,971 |
$139K |
| A0100 |
Non-emergency transportation; taxi |
4,288 |
1,537 |
$85K |
| A0090 |
Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest |
4,040 |
1,152 |
$55K |
| A0080 |
Non-emergency transportation, per mile - vehicle provided by volunteer (individual or organization), with no vested interest |
1,122 |
528 |
$9K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
224 |
178 |
$6K |
| A0170 |
Transportation ancillary: parking fees, tolls, other |
18 |
12 |
$106.00 |
| X5621 |
|
113 |
113 |
$0.00 |